Helmet safety encouraged on the grid iron

Lake Shore quarterback Will Bobek (center) leads a team breakdown after a recent practice. Bobek, who suffered a concussion last season, returns for his senior year at Lake Shore.
DAVID DALTON--for The Macomb Daily

Lake Shore quarterback Will Bobek (right) makes a handoff during a recent practice.
DAVID DALTON--for The Macomb Daily

Lake Shore quarterback Will Bobek was one of the lucky ones.

In the first quarter of last season’s opener against city rival South Lake, Bobek took a shot square to his chin.

The end result was a concussion, the second one according to Bobek, of his high school football career.

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“This one was much worse,” said Bobek, who was a junior last season. “I didn’t go to hospital the first time. It was like a little ringer. I went home and was fine the next day.”

Following his second concussion, Bobek sat out the rest of the game and missed the next two weeks.

“He ended up playing most of the first quarter against South Lake, but as it went along things were getting fuzzier and fuzzier for him,” Shorians coach Tom Iwanicki said. “He didn’t know who I was. He didn’t know who his dad was.”

Lake Shore followed the University of Michigan six-step play recovery.

“We did everything by the book with him,” Iwanicki said. “We took our time and struggled through it. Whether it’s a quarterback or an offensive lineman or the last guy on the bench, it’s the same for everybody. It was hard to be patient as a football coach, but as a person who cares, it was easy.”

Two days after the concussion Bobek could ride a bike, which was followed next by some light exercising, then jogging and finally back to running.

“Once the headaches stopped you began the protocol,” Bobeck said. “I had no setbacks.”

“If you get symptoms, you go back to step one,” Iwanicki said. “If you’re in step five and you get symptoms, you go back to step one, not step four. The kid has got to be completely honest. You’re relying on him.”

Football is a violent sport, even at the high school level, and will never be injury free. Stories such as Bobek’s deeply concern parents and coaches of high school athletes as another season is set to begin.

And for good reason.

In 2012, a study by Head Case, a web company that offers tools to measure head impacts and detect potential concussions, showed 47 percent of all sports-related concussions were suffered by high school football players and a third of those injuries occurred during practice.

Last October, the National Academy of Sciences released a 306-page report funded by the National Football League which showed high school football players suffer concussions at a rate of 11.2 per 10,000 “athletic exposures,” almost twice the rate of college football players.

“We’ve had several kids whose parents won’t let them play because of fear of getting a concussion,” L’Anse Creuse coach Don Roda said.

WHAT IS A CONCUSSION?

According to the Centers for Disease Control and Prevention, a concussion is a traumatic brain injury caused by an impact -- a bump, blow or jolt to the head, or a blow to the body -- that changes the way your brain normally works.

According to the Sports Concussion Institute in Los Angeles, the impact causes the brain, which is floating in fluid, to move quickly back and forth striking the inside of the skull and damaging delicate neural pathways.

Symptoms include headaches, nausea, difficulty concentrating, lost memories, irritability, sadness, sleep disturbances, changes in appetite and energy levels. Research shows repeat concussions can lead to long-term neurological damage, including memory loss, depression, personality changes and other serious illnesses such as progressive dementia.

SCI notes on its website that repeat concussions for adults are 2-4 times more likely after an initial injury. The adolescent brain is even more at risk for repeat concussions.

“I don’t think there are any more concussions than there used to be,” Roda said. “I just think people are more aware of what a simple concussion is. When we used to get our bell rung that was an everyday occurrence when I played, now it’s a concussion and you have to get the kid out and make sure there are no more problems.

“We have a couple kids with concussions already this season, just from tackling in practice,” Roda continued. “Sometimes they don’t have symptoms for the first 24 hours. They just get home and feel a little crappy and then all of a sudden they’re throwing up in the middle of the night.”

MORE RESEARCH

While there are no helmets, mouthguards, bylaws or coaching methods that can completely eliminate brain injuries in any level of football, there are ongoing efforts aimed at reducing the risks and preventing as many concussions as possible.

Dr. Jeffrey Kutcher is an expert on the brain. He’s the director of the Michigan Neurosports Program and an associate professor of Neurology at the University of Michigan’s medical school.

He also is a team physician for the university’s athletic department and has served as director of the National Basketball Association’s concussion program and provided neurological care to all U.S. athletes and National Hockey League players at this year’s Winter Olympics in Sochi, Russia.

Kutcher said helmets are not actually designed to prevent concussions.

“The role is to prevent a skull fracture and internal hemorrhaging,” Kutcher said. “A concussion occurs when the brain experiences a quick movement or a quick lack of movement. It doesn’t matter to your brain whether something hits your skull or hits your helmet.”

But Kutcher said where helmets really provide a service is in the long-term impacts on an athlete’s brain when a concussion is suffered.

“The overall concern isn’t necessarily preventing concussions but preventing long-term consequences,” he said. “You do want helmets to let the least amount of force through to the brain. What we don’t know is how much force we have to account for.”

The lack of research could soon change. Earlier this year, President Barack Obama hosted a youth sports summit at the White House and encouraged researchers to focus on understanding concussions and asked for tools to help parents, coaches, clinicians and young athletes to prevent, identify and respond to concussions.

Among the efforts announced during the summit:

• The NCAA and the U.S. Department of Defense will spend $30 million for concussion education and a comprehensive concussion study involving up to 37,000 college athletes;

• NFL will spend $25 million to create health and safety forums for parents and to get more trainers at high school games;

• National Institutes of Health, with $16 million from the NFL, will study the chronic effects of repetitive concussions;

• National Institute of Standards and Technology will spend $5 million to develop advanced materials to protect against concussions in athletes, troops, and others.

“We’ve got to have better research, better data, better safety equipment, better protocols,” Obama said. “We’ve got to have every parent and coach and teacher recognize the signs of concussions. And we need more athletes to understand how important it is to do what we can to prevent injuries and to admit them when they do happen. We have to change a culture that says you suck it up.”

Outside the government, researchers are focusing on youth concussions, too. The Washington Post recently profiled Bob Gfeller, director of a pediatric trauma institute at Wake Forest Baptist Medical Center in Winston-Salem, N.C., and father of Matthew, a 15-year-old football player who died in 2008 after a head injury. Gfeller told the Post that 70 percent of football players are younger than age 14 and they are the least studied. His institute is in the third year studying 9 to12 year olds tracking the cumulative effect of head contact.

HEAD PROTECTION

In May, Virginia Tech University released its latest ratings of the safest football helmets available, using analysis of helmet-mounted sensors and impact testing. The best helmets, of 23 models evaluated in 2,700 lab tests, reduced head accelerations and thereby lowered concussion risk. The best helmets earned a five-star rating. (See chart of best helmets).

The Macomb Daily surveyed coaches and athletic directors from all 34 Macomb County schools with football programs. We asked what helmet models they use, how often the helmets are reconditioned and how much the helmets cost.

The answers were consistent from the 31 schools that responded. All use the four- and five-star rated helmets made by Schutt, SG, Ridell, Rawlings and Xenith and identified in the Virginia Tech study.

Every school that responded said they recondition helmets every year and purchase replacements for $250 to $450 each, depending on the manufacturer, bulk discounts and the size.

It’s clear that school athletic departments spend thousands of dollars each year to provide top-rated head protection to their football programs alone.

“I think helmets are a lot better, but the better you make the helmet the more likely kids are going to use them to hit,” L’Anse Creuse’s Roda said. “You talk to the old guys and if you want to get the helmet out you take the facemask off. You don’t stick your face in then.”

New helmets can easily cost schools $10,000 to $15,000 a season.

Many teams rely on booster club fundraisers, parent purchases and charitable donations to pay for new and reconditioned helmets each season.

MORE PROTECTION

While helmets get lots of attention from concussion researchers, the kind of mouthguards young athletes use are just as vital to prevention efforts.

Dr. Jack Winters is a pediatric dentist in Findlay, Ohio, who is very close to the game of football. He was a Mid-American Conference referee for 20 years and currently scouts potential referees for the NFL.

He is also member of the Academy for Sports Dentistry and recently published an article in The Journal of General Dentistry focused on mouthguards and their role in preventing concussions in high school football players.

Winters studied six football teams in western Pennsylvania.Three were fitted with custom-made laminated mouthguards of various thicknesses and three used “boil and bite” over-the-counter mouthguards.

In a phone interview, Winters said mouthguards help players absorb blows below the chin, where impacts vibrate through teeth and jaw bones and into the skull, jostling the brain. The correct fit and varying thickness of the laminated guards were important to reducing the vibrations and resulting brain trauma.

How a mouthguard is treated also affects how well it can do its job. As a referee for 20 years, Winters said he saw players take mouthguards out between plays and put them on their helmets.

-- Developing policies for removing athletes from games and allowing athletes to return to competition.

In all sports, the MHSAA has a policy that if an athlete exhibits any signs, symptoms, or behaviors consistent with a concussion (things such as loss of consciousness, headache, dizziness, balance problems), that athlete shall be removed from the game and can’t return to competition that day.

MHSAA communications director John Johnson said it is up to referees, coaches, school administrators and trainers to look out for signs of a concussion and make the determination to remove an athlete from a game.

All varsity coaches in every sport are required by the MHSAA to take part in a rules meeting (in person or online) where a variety of issues are addressed, one of them being concussions.

If a coach doesn’t partake and go through a rules meeting, that coach is banned from coaching in the state tournament of their sport.

If a school doesn’t have a representative at the rules meeting for two straight years, the team is then banned from the state tournament for their sport.

Johnson said the MHSAA encourages concussion prevention by making sure every precaution is taken before allowing athletes with concussions symptoms to return to the field.

The only way an athlete can ever return to competition is by being cleared by a medical or osteopathic doctor, physician’s assistant or nurse practitioner.

“It’s something requires rest and that includes staying off your phone and staying off your computer,” Johnson said. “Rest means just that for the brain.”

Kutcher, who also consults the MHSAA, echoed the importance of rest when recovering from a concussion.

“If the athlete is removed from participation as soon as possible and cared for appropriately, it should not affect their health in the long term,” Kutcher said.

NOT GIVING UP

Despite what all the statistics say and how worried parents may be, many players who suffer concussions still find the allure of the game too strong to walk away from it.

“I wasn’t scared when I decided to come back,” Bobek said. “You always know there’s a chance you can get a concussion playing football. I was just ready to get back. I was anxious to play.”

Bobek, who returned wearing a Guardian Cap on top of his helmet, started Week 4 and finished with 1,400 passing yards in six games.

“The extra layer of protection seems to have helped us out,” Iwanicki said. “The kids got a bit more confident.

“I was one of the kids who had a concussion and didn’t know it,” Iwanicki added. “I walked to the wrong huddle when I was in 10th grade.”

Bobek said he’s ready to lead the Shorians this season from under center.

“It doesn’t worry me as much,” Bobek said. “You can’t prevent a concussion. If you play scared you’re going to get hurt. So just play.”

-- Digital First Media sports writer Keith Dunlap contributed to this story

About the Authors

George Pohly is the sports editor for The Macomb Daily. He covers high school sports, bowling and motor sports. He also blogs sports at http://georgepohly.blogspot.com/ Reach the author at george.pohly@macombdaily.com
or follow George on Twitter: @GPohly.